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Home My WebLink About127 jefferson st INVOICE DATE DUE DATE INVOICE# TOTAL DUE /ti'l .11,, % 05/02/2023 06/05/2023 202 -,inar��r 3 00011247 $80.00 Customer#: 23091 Please Make Check Payable and Remit To: City of Waterloo ATTN: City Clerk/Accounts Receivable HAB PETROLEUM 715 Mulberry St 127 JEFFERSON WATERLOO, IA 50703 WATERLOO, IA 50701 Amount Enclosed: DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT KEEP THIS PORTION FOR YOUR RECORDS COMMERCIAL INSPECTION- 127 JEFFERSON ST-4-19-23 FOR BILLING INQUIRY: (319)291-4323 l Description Total Price J INSPECTION 2,000 $70.00 OCCUPANCY FEE $10.00 CUSTOMER# BILLING DATE DUE DATE INVOICE# CHARGES 23091 05/02/2023 06/05/2023 2023-00011247 $80.00 Less Prepayment $0.00 Total Due — $80.00 City of Waterloo r Q RESCUE �Q WATERLOO FIRE �, lHi INSPECTION REPORT 2 NAB PETR OLEUM, ST,BLDG 127 JEFFERSON ST,WATERLOO IA 5070 DETAILS Inspection Date:04/19/2023 ; Inspect ion Type:Annual Inspection(1Yr) Inspection Number:9828 Shift: N/A Station: N/A Unit: N/A Lead Inspector:JEFF SIEBEL Other Inspectors: N/A Fee:$80.00 STATUS CODE DESCRIPTION 'L 2305.2.2-Repairs and se rvice. The fire code official is authorized to require damaged or unsafe containment and dispensing equipment to be repaired or serviced in anapproved Inspector:JEFF SIEBEL-Comments:Repair:A.Fuel Dispensing Monitor has High Water Alarm B.Pump 3 OOS C.Pump 8 OOS erman nt wiring FAIL 603.6-Extension cords. Extension cords and flexible cordsshall not be a substitute for p cords end flexibl and shall be listed and labeled in accordance with UL 817.Extension cordsshall not be affixed to structures,extended ds be subject to ehrough walls, 'n ngronmleontal or rs,or under doors or floor coverings,nor shall such II ! = ,£ `" /, damage or physical impact.Extension cords shall r be se Busedll n of only b wised outdoors. i.`°` th portable appliances.Extension cords marked for indoo Inspector:JEFF SIEBEL-Comments:A.remove extension cord to window lights,install -_,1. permanent power with permits and inspections. A n.,........„::14N,\•• 14 , , t, -''' tut". 4 v" FAIL 704.1 intainin Where required when the building was originally locationsconstructed, ted,shall materialse ined and systems -Mag protection. used to protect joints and voids in the following materials and systems shall be securely attached to or bonded to the adjacent construction,without openings visible through the construction. 1.Joints in or between fire-resistance-rated walls,floors or floor/ceiling assembliesa the intersect roof of a or roof/ceiling assemblies.2.Joints in smoke barrie rs.horizontal floor assembly and an exterior curtain l.4.Voids at the intersection of a 5 Voids at the intersection of a horizontal smoke barrier and an exterior curtain wall. nonfire-resistance-rated floor assembly and an exterior ecortcinrain wall. dsoids at at the intersection of a vertical fire barrier and an exteriorly. intersection of a vertical fire barrier and a nonfiretlroof h joints an Unprotected joints and voids do not need to be protected where uc voids were not required to be protected Nrnberhs known ghe system originally shall be constructed.Where the system design n inspected to the listing criteria and manufacturer's installation instructions. Inspector:JEFF SIEBEL-Comments:replace missing ceiling tile in cash checking area. GENERAL NOTES Printed on 04/21/2023 @ 12:15 Page 1 of 2 JEFF SIEBEL-04/21/2023 @ 12:12 annual inspection$80 REINSPECTION DATE 05/12/2023 CONTACT SIGNATURE Brittany Even L Signed on:04/21/2023 @ 12:13 <J INSPECTOR SIGNATURE JEFF SIEBEL Signed on:04/21/2023 @ 12:13 QUESTIONS ABOUT YOUR INSPECTION? JEFF SIEBEL Jeff.Siebel@Waterloo-ia.org 3192301224 Printed on 04/21/2023 @ 12:15 Page 2 of 2